Archived: Glebe Park Surgery

Updated 16 March 2016

Glebe Park Surgery is a small two partner practice situated in the north of the city of Lincoln. The practice is based in a converted bungalow and is in the centre of the residential estate that it serves. There is no car park, however on street parking is accessible around the building.

• The practice has two partners (male and female) and a salaried GP (female) and a locum GP. The practice employs a practice manager, one practice nurse and a health care assistant along with three administration staff and a cleaner.

• The practice is open between 8.30am and 6pm Monday to Friday. With appointments available in these times. Extended surgery hours are offered Mondays until 7.30pm.

  • Out of hours care can be accessed by calling the surgery telephone number or by calling the NHS111 service.

• The practice list size is approximately 3900 and patients are predominately between the ages of 15 and 65 with relatively fewer adults over the age of 65. The practice has a higher than average deprivation score compared to other practices in this Clinical Commissioning Group (CCG).

• The practice lies within the NHS Lincolnshire West Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice is registered to provide; diagnostic and screening procedures, surgical procedures and the treatment of disease, disorder or injury at Glebe Park Surgery, 17 Montaigne Crescent , Lincoln , LN2 4 QN.

Glebe Park Surgery has not been inspected previously by the Care Quality Commission.

Before the inspection it was noted that the practice was not registered for the activity of maternity and midwifery services. The practice was notified of this and the practice manager had made steps to rectify this.

Updated 16 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Glebe Park Surgery on 21 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with kindness, dignity and respect and they were involved in decisions about their care and treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the Duty of Candour.
• The provider was not registered for the activity of maternity and midwifery with the Care Quality Commission.
• The practice did not have a patient participation group in place.
• A legionella assessment had not taken place at the practice however this was booked to be completed the week after the inspection.
• Not all staff had completed formal MCA training however staff were able to demonstrate an understanding of the act and could relate it to their roles.
• Staff files did not contain references for staff employed as stated in the recruitment policy.

The areas where the provider should make improvement are:

• Ensure a patient participation group (PPG) is in operation.
• Ensure registration is updated to include the maternity and midwifery activity.
• Ensure any actions identified from the legionella assessment are acted upon and the infection control policy is updated to include this.
• Ensure that staff files are kept in line with Schedule 3 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and that the practice recruitment policy is adhered to.
• Access MCA (mental capacity training) for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 March 2016

The practice is rated as good for the care of people with long-term conditions.

• Community specialist nursing service provided support and education for patients.

• Diabetic indicators for the practice were 91% which was the same as the CCG average and 1.5% above the national average.

• Longer appointments and home visits were available when needed.

• Patients that did not attend for monitoring were picked up when prescriptions were requested and booked for appointments.

• Same day access was available to patients that have been highlighted as at risk.

Updated 16 March 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, the practice then flagged these patients onto the clinical system so that all staff were aware.
• 89% of patients diagnosed with asthma, on the register, had an asthma review in the last 12 months compared with the CCG average of 80% and the national average of 76%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 82%, which was comparable to the CCG average of 84% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered opportunistic pre-conception counselling including rubella status, alcohol/smoking cessation advice and folic acid prescriptions.

Updated 16 March 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice worked alongside care home staff for support and advice.

• All patients over the age of 75 had a named GP.

• Patients that were admitted to hospital were assessed to look at ways to prevent future deterioration or admission.

Updated 16 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice offered telephone consultations.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 16 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice held a register of patients with serious mental health illness. All these patients had a careplan in place and were offered an annual physical health check.

• 94% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 83%.

• The practice carried out advance care planning for patients living with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Patients were able to self refer to community mental health services.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• Patients that presented in significant emotional distress were offered an appointment on the day.

Updated 16 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of vulnerable patients who refused support from other services and offered extra support and advocacy to these patients.

• The practice provided general medical services for vulnerable adults in a neurohabilitation facility.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations such as St Barnabas for those with a life limiting condition, an advocacy service, citizens’ advice, housing advice and substance misuse services.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• The practice had recognised the lack of annual checks for patients with a learning disability. Training had been arranged for all staff and clinicians and checks for these patients were due to commence in May 2016 following the training.